Neuro 11:2 PDF

Created with Coconote - https://coconote.app Neuro 11:2 Class as well. I have no limit on the number of slides, so have as many slides as you need to tell your story. I don't know how many that is. It might sometimes you might have a slide that you spend a lot of time on, and other times you have...

Created with Coconote - https://coconote.app Neuro 11:2 Class as well. I have no limit on the number of slides, so have as many slides as you need to tell your story. I don't know how many that is. It might sometimes you might have a slide that you spend a lot of time on, and other times you have a slide that you just display very quickly. So however many slides work best for what you're talking about, I don't have a limit. I mean, you don't want a 100. Needs to be a reasonable number. But whatever you can prove are best. So I just wanted to clarify that. So Anna Maria had, like, 10 a 10 slide limit or something like that? No. It was just 10 minutes. 10 minutes. It was the same timeline as yours. It was 8 minutes and 2 quest 2 minutes per question. But not slide No. Okay. Well, I don't know. She suggested she suggested, like, a minute of slide. A slide a minute. Yeah. So a a slide a minute is a really common guideline. However, you have to take into account, like, what you're talking about and what the purpose of the slide is. And sometimes you might have many more and sometimes you might have many less. And, like, like, I don't have a slide a minute. And in my 3rd year seminar class where students do a seminar for an hour and 15 minutes, they don't have, what, 75 slides. So you you really have to, look at what works best for your purposes. And if you want some suggestions, ask me. I think I do have some suggestions on how to make good slides. Don't I put some I think I did in the handout. One thing I would suggest is don't have too much text. You can't listen to people speak and also read extended text, so keep your slides to the core points only. Use visuals as much as you can to express an idea. It's always easier to look at a diagram or a picture and have someone explain it as opposed to reading. So those would be some core suggestions. How do you feel about a short video? Sure. Yep. If it's not, like, I don't want, like, a 5 minute video and an 8 minute presentation. But if you have a short clip that demonstrates something well, absolutely. Yeah. Whatever works best for your purposes. And if you have questions about something you're considering doing, just ask. Alright. So this is from your textbook, and what it shows is some of the symptoms that would occur when you have fluent aphasias or disorders of comp comprehension, and some of the, actual symptoms that would occur when you have non fluent aphasias or disorders of production. So like I said, with disorders of comprehension or fluent aphasias, you can have difficulty understanding spoken language. So when language is coming in through the auditory modality or when it's coming in through the visual modality, and what that's referring to is reading. In non fluent aphasias, you can have poor articulation. That's a more motor aspect that goes along with the, language production problem. But the core problem is linguistic in nature, Meaning that you actually have trouble finding the word. And that is a symptom in and of itself known as anomia. I believe I played it, but I can't remember the premise through the board game Enomia or a card game. So what is it? You get a card and it might say, like, a breed of dog or something like that. You have to I didn't know that I'm like, maybe this is like a defensive thing for this game, but I was, like, I was obsessed with this game when I was younger. My friends and I in middle school literally played it, like, every day. And basically, you have, like, category cards and you, like, match symbols. So it'll be, like, broad categories, like, name a celebrity or tennis player or whatever. And if you match symbols, you have to say what's on the, like, something on that's on the other person's card rather than your own. So it, like, trips people up. And then, like, the promise if you get too good at it, like, we were all so good. Like, no one wants to play it. I can tell you we're obsessed with it. No. Literally, this is, like, my, like, core favorite game. Like, it was never, like, normal cards. It was, like, specific to this game. Yeah. So the the makers of this game clearly did a little research into the aphasia world because this is a a clinical term. Anomia means, like, a word retrieval problem. And, like, we all have moments of anomia from time to time, like, when you have have, you know, when you have a word on the tip of your tongue or, like, a name and you know you know what it is, but you just can't come up with it, that would be anomia. But when people have this deficit to, like, a moderate or severe extent, it would be considered a part of aphasia. People who have disorders of production also make errors, and that's what paraphasia refers to. They so with anomia, you don't generate a word. With a paraphasia, you come up with something, but it's an error. And there's different I have some examples to show you in a few minutes, but there's different types of paraphasias. You can have what's known as a phonological paraphasia. So for example, instead of saying the person's trying to say the word table. Instead, they say tackle. So it's similar in sound, in phonology, but it's not correct. Or you might make an error that's a semantic paraphasia. So instead of saying the word table, the person says chair. So a paraphasia is an unintended word. It's an error. It's a mistake. Anomia, they just can't find the word. Loss of grammar and syntax, as we'll see people who have non fluent aphasia, their sentence structure is extremely simple. Adjectives, verbs, prepositions, all the little words, the functors, they're generally absent. They speak and this is a clinical term as well. They speak as if it's like a telegram. Dog, leash. Outside, they can't say I put the dog on the leash and put the outside. All the little words are gone. Inability to repeat what they hear. Low verbal fluency just means they don't say very much. Difficulties with writing. And a lot of this goes, often a lack of prosody. So there's not much changes in frequency or a lot of contour in their, speech. This is from your textbook as well. You don't need to memorize all these different things. We'll talk more about this next term, those of you who are in the SLP program. But there are fluent aphasias. There are non fluent aphasias. And, traditionally, there's 7 categories. There's Wernicke's aphasia, transcortical sensory aphasia, conduction aphasia, anomic aphasia. And in the non fluid aphasias, there's Broca's aphasia. Here, they've broken it down into severe and mild, transcortical motor aphasia, and global aphasia. And we'll be talking much more about what these are, how to assess them, variations in them, recovery of them, and so forth, next semester. What I'm gonna do now is just talk about a couple of examples, and we'll look at a video, sample of each. So Wernicke's aphasia is the prototypical fluent aphasia. People have difficulty understanding or repeating speech and usually and repeating. They shouldn't say or. They should say and. And repeating speech that's produced by other people or something that they would say themselves. Their language is generally fluent, like the, gentleman we saw in the video, meaning that they don't have problems with articulation, but it's jargon like. And what that means is that there are a lot of overused phrases. They might say things like, oh, whatever, you know. Oh, fine. Thank you. Oh, what a lovely day, and so forth. All these sort of overused phrases that somehow seem to be stored in the brain in a different way. They come up effortlessly, but they're not right in context. They don't make sense semantically based on the environment that they're in. That's what jargon refers to. They might also make paraphasias. That's word errors. They might have anomia, word retrieval problems. And what neologisms these are all defined in the text, but what neologisms are, paraphasias are errors that you can see the relationship. So it's semantic, so they say chair instead of table, or they say tackle instead of table. What a neologism is is a sound that has absolutely no relation as far as you can tell to what the actual object is. So instead, they're trying to say the word table, and they say, pivot or something. Like, just something that has absolutely no phonological or semantic relationship, and we'll look at some, examples in a minute. So neo, I always think of it as being like like nonsense. It's like a nonsense sound. Okay. So it's like a non It's a non word. A phonological paraphasia would also be a non word, but you can see the similarity like tattle. I can't even figure out what table, tattle. A neologism would be table, my mind's not working. Table what would be are you giving an example? No. I have a question. Okay. So is it only neologism if it's, like, a non word? If they're, like if it's another word that's a perfectly good word but completely semantically separate from what we're getting at? It's a it's a different type of paraphrasing that we haven't talked about. Don't worry about it now. There's there's a whole bunch of different classification systems for classifying errors, and we'll look at these in detail next next time. Alright. But, yes, you can make what's called a formal paraphasia. That's another word that is a word, but it doesn't correspond to what the object is. So, anyways, I have to come up with an analogism because this is bothering me. Instead of table, the person says or something. So there's, like, no relationship that you can see, and it's not a word. Interestingly, often Wernicke's aphasia accompanying it, people seem unaware of their difficulties. So they have the sort of global semantic impairment where they can't appreciate that they're not making sense. And this actually has a clinical term some of you may have heard of. Anoagnosia means unawareness of deficit. And it's not just with aphasia. You can have, like, someone who has Alzheimer's disease and doesn't understand that they have memory problems would have anoagnosia, failure to appreciate that they have memory difficulties. So it means unawareness of their cognitive or behavioral difficulty. So here's a language sample, from someone who has Wernicke's aphasia. And the person's asked, what kind of work did you do before you came into the hospital? And they said and they would have been quite fluent in saying this. They said, never now, mister Oig. I wanna tell you this happened. When happened when he rent his his kell come down here and as he got rent something, it happened in these rope years where with him for high is friend, like, was, and it just happened so I don't know. He did not bring around anything front of his in these floors now, so he hadn't had around here. So the person would say it quite effortlessly. It would come out, like, without, they're not struggling to articulate, these phonological sounds, but does it make sense as far as you can tell? Did they understand what was being asked? Probably not, although you never really know what's going on in somebody's head, but it doesn't look like they understood. What are some examples of the different types of symptoms? Like, find me find me a piece of jargon, an overused phrase that but that is an act actual phrase. It happened or that just happened? It happened. He hadn't had them around here. They're sort of, like, collections of words. They don't say a whole lot or mean a whole lot, but it's a legitimate, like, overused expression probably. What about a it's hard to tell what are neologisms versus paraphasia because we don't know what's going on in their mind, but we certainly see lots of errors. Right? Like, mister, oiage, ran, pedis, is, pesed. So lots of word errors. So neologism is probably paraphasias, overused jargon, and a comprehension difficulty. Any other comments? I think also the length of his response really shows that he's not aware, but he's not comprehending as well. Absolutely. And this would have come out, like, effortlessly and often, people will will speak quite quickly. And I'll show you we'll look at another video in a minute. What was there? Sorry. Yeah. I was just gonna ask, like, if you were to tell them that they're not making sense, would they actually comprehend the fact that you're telling them that that makes sense? So this is someone who has a significant level of impairment. So if you were to say to them, I'm sorry. I didn't understand what you said. Could you tell me that again? They'd probably come up with another utterance that was different, but was similarly nonsensical. However, in a milder case, they might under it wouldn't look like this. There would be pieces that did make sense, but overall, it would still be pretty jumbled. And then if you were to ask for clarification, maybe they would try again, and it might make a bit more sense. Right. So there's varying degrees. With all of these disorders, what I'm showing are the pretty extreme examples because I think they highlight it best. But with anything, there's gonna be varying degrees. So this might recover into something where they just have difficulties coming up with specific words that are low frequency. So they can say table, chair, you know, light door, but they can't they can't come up with the word, you know, justice or, like, something that's, like, low frequency and not commonly used. In terms of what is going on in the brain, what this shows is that the most common area oh, yes. Sorry. I just have a question. So when you have someone, like, like, where they can't comprehend what you're asking, how would you navigate treatment in order to get them to do the treatment if they're not understanding what you're asking them to do? You would most likely do things like work on making the environment as functional as possible, and that would include working with, like, the family and the caregiver and whoever else within their life to try to make communication as efficient as it could be. I don't think not everyone would agree with this, but I do not think you can take this level of impairment and, like, retrain the comprehension system. It and and, do a sort of more restorative based types of type of treatment. Yeah. It's hard to correct something if you're not aware. But you can do a lot in terms of making their environment more functional and then also trying to improve their quality of life. So someone like this can still have, like, a meaningful life through doing things that don't rely as much on language, and you can help as an SOP facilitate those activities. So when something that's, like, kind of this severe, it'd be more like finding their strengths and trying to use that to make Absolutely. Yeah. Absolutely. Yeah. So the video we saw of the person who was, whatever scientist, so he's probably not gonna have recreational pursuits that are really language based. But maybe there's outdoor activities or maybe he likes photography or maybe there are maybe he can be involved in art or, there's also in that way, your job almost becomes a bit of a recreational therapist. And I in that, you're helping people work around and find meaning meaningful pursuits in life that don't involve language. And then working with the caregivers to say, okay. When when we really have to do something that's language based, how can I best communicate with this person? Can they understand gesture better? Can they read better? Can they understand, you know, like like visual, more that sort of visual pictorial types of things? Like, what are the person's strengths and how can it communicate within the best? As opposed to we're gonna retrain the semantic processing system. Okay. That makes sense. Does that If it's a lot less severe than this, is it possible to retrain any of the systems? There are pros there are it really depends on who you ask. There are semantic processing methods. I don't think the evidence is really strong that they work. And if they do work, it's very it doesn't generalize. So maybe you can, like, in an individual session, have a set of words that they can, you know, match the word to the picture better in that session? When they leave, can they do that at home? There's not much evidence that that happens, and studies also haven't looked at it. So I'm not really a perm a proponent of that. But not everyone that's just my viewpoint. Okay. So in terms of the lesion site, like with all of these disorders, the most common lesion site would be to Wernicke's area itself. But what this is showing is that you can actually have lesions anywhere in the left hemisphere. Well, you can even have them in the frontal lobe. It's not in this diagram. But you could have lesions elsewhere in the brain outside of Wernicke's area because what you're doing is you're disrupting the network, so input or output out of Wernicke's area. Does that concept make sense? So you can have this function be affected because the input can't get in or the output can't get out. And that's how the brain works, is by these networks. Okay. Here's just another brief example of someone who has, fluent aphasia. You can it's it's on bright space as well. Hi, Byron. How are you? I'm happy. Are you pretty? You look good. What are you doing today? We stayed with the water over here at the moment, talked with the people over there. They're diving for them at the moment. With that statement, the moment, he had water for some for him with luck for him. So we're on a cruise and we're about to take care of you. Right here, and they'll save their hands right there for them. And what were we just doing with the iPad? Right at the moment, they don't show a darn thing. The iPad that we were doing. Wait. Like, here? I've got my change for me and change hands for me. It was happy. I would talk with Donna sometimes. We're all with them. Other people are working with them and them. I'm very happy with them. Okay. This girl was fairly good and happy and I played golf and hit up trees. We'd play out with the hands. We save a lot of hands on hold for people's for us, other hands, other what you get, but I talk with a lot of hand for him sometime. Am I talking any more to say any? Alright. So what you can see there is a similar pattern to the other gentleman. What he said didn't make a lot of sense, although there were bits that I think near the beginning when he mentioned the water and whatnot that had a bit of context, a lot of jargon, like, sort of overused phrases. He also had this sort of presentation of seeming to not care. So this sort of anoagnosia presentation. He's not he's talking, but he doesn't seem aware that what he's saying doesn't correspond to the questions he's being asked. Is that a hand? Yeah. Yeah. Do you think comprehension of the jargon, like, phrases is higher? Like, if you were to repeat at the moment, do you think you would understand that better than the incentives? I don't know because I've always viewed jargon as being sort of it's like something that is somehow wired in the brain in a more automatic way. So I think it's just almost coming out as sort of like an automatism. Like, it's not it's not meaningful. It's just a string of words that somehow got stored in the brain in a collective, like, collectively, and then it comes out once the language pathways get activated. So I don't think he would, but, I don't know. That's what I was thinking. Yeah. Is that what you were thinking? Yeah. Yeah. Okay. So Boerne case aphasia is the prototypical fluent aphasia, and the cases that we've looked at have been pretty severe in nature. The mildest esplenoid aphasia is something known as a nomic aphasia. And what that is is when people usually, people recover into this, meaning that they would have Wernicke's aphasia or Broca's aphasia, and then they make a really good recovery over time. But they're still left with difficulties finding specific words. So some days, especially if I don't have a good night's sleep, I feel like I have an omic aphasia. Words are on the tip of my tongue, but I cannot find them. Nothing comes out very fluently, and I just can't find the words that I wanna use. I don't have anomic aphasia. But people who have anomic aphasia would have good comprehension for the most part, good production for the most part, able to repeat things that are said to them, but they can't come up with specific words. Not all words, but, some words, it would vary from time to time what words were affected. But they know what they're trying to say. So this is from this is from a this is an example from a patient I saw, a number of years ago. There's a test, and, one of the test items, there's a picture of an igloo. And the person said, I know what it is. It's made of snow. People in the Arctic live in them or they use them as shelter. And then he went on and he said, it's made up of blocks. It's kind of a snow and you stack them. So he was completely, like, able he he knew what it was. He recognized the picture. He knew what he wanted to say, but he couldn't come up with the word. And so that's what anomia is. You can't come up with the word at the specific point in time. So anomia can be a symptom of anaphasia, but when it's pretty much the only difficulty, then it's known as anomic aphasia. It's a disorder in and of itself. And, typically, it's something that people recover into. So the gentleman we saw on the video, maybe 5 years after that, if he's lucky, he has anomic aphasia. That would be a fantastic recovery, but you do see it. I assume someone had, like, Broca's or aortic piece of patient, and then they have this is it a recovered Broca's aphasia patient, or is do they, like, have this new diagnosis? You can change diagnosis as time goes on, and we'll talk about are you in speech? Yeah. We'll talk about that next term. Okay. Yeah. You can change diagnosis. What you what never happens is you never go from a fluent category to a non fluent category or vice versa, but you can go from a Broca's aphasia to a Transcortical Motor aphasia or a Broca or a Wernicke's aphasia to an anomic aphasia or a Wernicke's aphasia to a Transcortical Sensory aphasia or something like that. You never change you never go from one big category to the other, but within those, you can change over time for sure. I didn't know there were some fluid recess. Yeah. Broca's aphasia is the prototypical nonfluent aphasia, and it's the one as a clinician that you will see the most commonly most commonly because people are usually acutely aware of their difficulties, often really wanting to work on them because they're very frustrated by the difficulties that they're having. It's when people have difficulties producing language. In its core state, it's the mental representations. It's not the motor production, but you can have some articulation problems go along with coming up with the actual word. There's speech. We'll look at some samples in a minute. It's slow. It's very labored and effortful, and it has this, like, telegraphic pattern, and that's a clinical term. So people will just say the, like, the core nouns that they need to communicate their message, and it comes out in a very slow way, and it's very effortful for them. Understanding is relatively good, but sometimes I get difficulty with complicated syntax or grammar. So for example, there's on one of the tests of aphasia, there are some complicated syntax items and there's things like, the giraffe who the lion was chasing was fast. Who was fast? The giraffe. But you really have to think about that. Right? So someone with broke his aphasia might have difficulty with putting all the syntactic pieces together with understanding the nouns and so forth, but their comprehension generally is pretty preserved. And usually, they're very aware of what has happened to them and the changes that they're they've experienced. And often along with this, they're very frustrated. There's a very high rate of post stroke depression in people who have broke dysphasia because of the enormous impact that, has had who have broke dysphasia because of the enormous impact that, has had on their life, and and they understand fully that this is not how who they used to be. So here's another speech sample from someone who has broke his aphasia, and they would say this, you know, this might take 5 minutes to utter. I won't read it over 5 minutes, but they say, so the question is why did you come to the hospital? Monday, dad and Paul and dad, hospital to, doctors and, 30 minutes, and, yes, a hospital and or Wednesday, 9 o'clock. Doctors, 2 doctors, and, teeth. Yeah. Fine. So do you think they understood the question? As far as we can tell, sort of makes sense. They have it's telegraphic. Most of what they're saying are nouns or pronouns. There's not a lot of prepositions, adverbs, all the the little parts of speech. And I'm not exaggerating when I would say that this might take, like, 3 or 5 minutes to utter. This would be extremely difficult for somebody. Anatomically, the most common area that's affected is Broca's area, but you can affect any part of the language network, like down here in Wernicke's area, down here in the anterior tip of the temporal lobe. Anything can disrupt the network, so to speak. But Broca's a lesion to Broca's area itself would be the most common, area damage. So let's look at someone who has a broke his aphasia. This person's it's sort of moderate severity. Can you tell us your name? Mike Caputo. And, Mike, when was your stroke? I was, 7 years ago. Okay. And And what did you used to do? Well, worked, on a desk, 7 7 sales sales and worldwide, and very good. Yeah. Okay. And who are you looking at over there when you turn your head? My wife. Okay. And why is she helping you to talk? She's a speech So you have trouble with your speech? Yeah. Yeah. And what's that called? Fascia. Alright. And so why don't you work now? I I well, I do And what do you do now? Voices of Hope of Asia. And what is Voices of Hope? Peter Berg, Peter Berg, and, doctor Hinkley, and and myself, founder founder for me. And, I I Okay. So that gives you a bit of a sense. So what do you think about this fella? How's his comprehension as far as you can tell? Pretty good. He's not being given really complicated things to understand. He might have more difficulties, but if she were to give him a really complicated statement and ask him to understand it, he'd probably ask for clarification. He'd appreciate that he didn't understand it. But with these more basic questions, he seems to certainly understand. Is what he's saying, like, appropriate in semantics? Yeah. You can tell sort of what he's trying to say. It's not as severe as the transcript, that I had, on the slide. But what do you notice about his speech production his language production? It seems like he's having some troubles finding some words. He's having troubles retrieving words. Did you hear some errors? There were lots of errors. It's hard to know if they're paraphasias or neologisms neologisms because he don't exactly know what he's trying to say sometimes, but he's definitely making word errors. What, what part of speech, like, predominated? Like nouns, verbs? Nouns. So it's telegraphic. It's mostly the nouns that are coming out. His speech rate is slow. I get the sense I don't know this individual, and I get a hit the sense that his stroke was probably some time ago. So he doesn't seem especially distressed by it, but, definitely, he seems aware of his problems. And had this been earlier, he might be showing, like, extreme, like, frustration in in trying to, communicate. Anything else that was relevant? Does he have, like, any right sided paralysis? Because his right arm is kinda just, like, sitting there. Probably. So when people have aphasia, they very commonly have right hemiplegia or right, hemiparesis, which can be complicated, because that's gonna affect writing. It's gonna affect mobility, and there there are opportunities to engage in social communication and do functional communication tasks. So motive deficits very common that go along with aphasia. I know this is maybe, like, a big question, but I'm just very curious because I know with, like, stroke recovery, a lot of the recovery kind of happens in the first, like, months to maybe a year. So if someone had a stroke, like, 7 years ago, if he's continuing to, like, see speech pathology, do speech therapy, is he still going to, like, keep recovering, or is this kind of like, is there a point where it just plateaus? Yeah. So what tends to happen and again, this is a a generalization. But what tends to happen when you look at the actual core language skills so here's 50 words that they have to name 50 objects that they have to name. How many can of those objects can they name? How many things can they repeat? When you actually look at core language skills, you see, like, the biggest rate is in the 1st weeks to months. And by the time you've hit about a year, a lot of the recoveries when you're looking at impairment is pretty leveled off or plateaued. However, people can continue to make functional gains, learn ways to work around their problem, continue to improve their quality of life. So he mentioned Jack he said the word Hinkley. Jacqueline Hinkley is a really well known SLP in the US who does research on quality of life in aphasia. So he I think he's in one of her groups. So, like, for decades, people can continue to be involved with speech language pathologists. But I would say it's in the earlier stages that you would work on actually trying to improve the impairment. Mhmm. Does that make sense? And the brain itself, even if a person never saw a speech language pathologist, the impairment just because of the way the brain works, it it on its own, it's gonna improve to some extent. So there's lots you can do, but where you tailor your efforts is gonna be different depending on the point at which they are at. That makes Does that make you feel special? Yeah. That's great. Thank you. Okay. And then local aphasia is just like what it sounds like. It's, the most severe form of aphasia. It's termed a non fluent aphasia usually, but people have difficulties comprehending, producing, and repeating speech. So essentially, Broca's area functions, Wernicke area functions, both are lost, and usually people have massive left hemisphere strokes that cause this. They may recover to some extent, but this tends to be a very severe, form of operation. Sometimes there can be little automatic phrases that can be spared. So they might be able to count or say the days of the week or say, like, hello. How are you? But that would be all they could say. So difficulties understanding and difficulties repeating. So it's a global form of aphasia. Okay. Just to, clarify, aphasia is a language problem. It's a cognitive problem. Problem. It's different than dysarthria, which we've talked about already, which is a motor speech problem. So what dysarthria is is when you have difficulties with speech because of something in the neuromuscular system, and the type of difficulty that you'll have depends on where the problem is. So if you have basal ganglia dysfunction, you might have a hypokinetic dysarthria like in Parkinson's disease, where people articulate speech poorly, very low volume, slow rate, low porosity, and so forth, but it's a motor problem. Or maybe they have Huntington's disease, which which is a hyperkinetic dysarthria. They actually speak very quickly, and there's, like, not distinctions between the words and the porosity is there and it's not appropriate, it's exaggerated, or maybe they have a cerebellar dysarthria and ataxic dysarthria. There's all different forms of dysarthria, and I just want you to understand that that's very different than aphasia. Aphasia is a cognitive problem, a mental problem. Okay. That's kind of a logical no. Is your is your brain is your cognitive powers okay to Talk very briefly about memory and then we'll talk about the more subtle well, let's do a couple slides to get us to a logical point. So we're moving on to another really important function and that is memory. And memory, I know many of you have taken psychology or neuroscience, so you'll be aware that there are many, many, complex models of memory. But the most basic way that memory has been looked at is in terms of long term memory and short term memory. And then there are subdivisions within each of these types. So long term memory would be things like, where you live, where you were born, the name your mother's maiden name, the name of your high school biology teacher, information that you stored a long time ago that is somewhere in, like, the neural circuitry of your cortex, and it's in a long term permanent storage, vestibule. Short term memory would be things like, you know, the pocket that you put your phone in a minute ago. Like, what the last what was on the last slide? If I say to you, here's somebody's phone number, like, you know, 816 1234. You can say that back to me. You have it as some kind of short term storage facility, and you might retain that for a couple of minutes before you forget it. That would be a short term memory. And within long term memory, you can break it down further. So there's what are known as episodic memories and the way the reason that these terms developed is because they they mean something. So what an episodic memory is, is, memories that you can consciously recall that are episodes in your life. They're specific to you. So if I were to say to you, like, tell me about your first day of school. Your story would be very different than your story. Your memories are different. So it's an episodic memory. If I were to say, like, tell me what you did on the weekend, even though there may be lots of commonalities you all studied, I'm guessing. But the episodes that got laid down in your memory that related to what you did over the weekend, they're long term memories. They're in there. You might not remember them forever, but the weekend is coded in some way. But there are episodes that are specific to you, and these tend to be things that are personal or autobiographical. Different from this are semantic memories, and these would be collective things that we share. So if I were to say, like, what's an apple? We all probably share a common memory of what an apple is. An apple is a fruit. They're red. They're green. They have stems. You can use them in baking. You can eat them raw. You can find them at a farmer's market or the grocery store. Right? So there's a basic semantic definition. We probably all share something similar. Or if I were to say, like, what's the capital of Canada? Memories refer to understanding things or concepts, words, objects, facts, or shared memories. Episodic memories are specific to each one of us. Those are conscious memories. Memories. Unconscious memories, also known as implicit memories, refer to things that we can do that we get better with experience but we don't necessarily consciously, recall them. So for example, if you practice riding a bike, you're gonna get better over time. So if you get on a bike for the very first time, chances are you're gonna have difficulty. But 10 times later, you'll probably know how to ride a bike. That's something that you have learned. You've gotten better with over time. It's a skill, but it's still a memory. And that would be an example of an implicit memory. Or for example, there's a task, that a famous patient, was given where you have the tower of Hanoi. You have these dowels and then you have these rings, and you have to get the rings over to a different dowel with the fewest number of steps. And even though we'll talk about h m in a couple minutes, but even though he had no explicit memories, he could do this task once he had learned how to do it. He couldn't explain how he was doing it, but he got better with experience. And then lastly, emotional memories would be things like they're usually vivid, they bring back a whole flash of experiences when they happen. They might be related to something that you smell, you know, the sound of your mother's voice, or seeing, you know, seeing a picture of the house that you grew up in when you were 5 years old. There are memories that may be positive or they may be negative. So h m, the famous amnesic patient, they used to do very unethical things decades ago, but they have an example where I might have told you this. The doctor went to meet and he put a he had a thumb tap in his hand. Did I tell you this? And he shook his hand, and the got poked. He couldn't remember why he didn't like the doctor, but he didn't want to go anywhere near him, and he associated all these negative emotions with him. So somewhere, his brain coded that something unpleasant and painful was associated with that person, and he should avoid them. So that would be an emotional type of memory. These different memory systems have different circuitry in the brain. And so what you what can happen is you can have someone like HM, the famous amnesic patient who had absolutely depleted explicit memories, but implicit and emotional were left intact. So brain damage can affect different memory circuits and, we'll look at some examples of that shortly. So why don't we take, it's 10:18 now. Why don't we take, like, a 10 minute break and then we'll talk about, memory score.